Intensive Care Units are often extremely busy, full of critically ill patients battling dis-ease: sepsis, organ failure, stroke, heart attack, respiratory failure and other life threatening disorders.
In my unit, at the start of the shift, we meet as a team to discuss the state of the unit and who will need help with the sickest patients. Before we even start our shift, we already have a sense of the chaos we are about to step in to. So, we brace ourselves and get down to business, as a 24 hour team, picking up where the last shift left off.
It was a Friday night, where I found myself feeling burnt out, irritated and frustrated with how busy and chaotic things were. It felt like there wasn’t enough time to complete the pages and pages of doctors orders I just received on both my patients. I felt frustrated with the lack of supplies in my patient room and the time I spent looking for and stocking new supplies. I tried to calm my frustration by organizing my area and making a plan to prioritize the nursing tasks and activities that needed to be completed. Yet, there still wasn’t even enough time to do that, so I moved on to the next critical task: charting, looking for missing medications, drawing labs, noting the results, checking blood sugars, performing neurological exams and titrating drips. I found myself tense, taking shallow breaths as I realized more medications were due and it was already time for another pupil check.
The shift flew by and it was already close to 5am when it was my turn to take my patient down to CT scan to check on the status of the swelling and his “brain drains”. As usual, it takes longer to prep an ICU patient for transport than it does to perform the actual CT scan. So, once we (me, the Resource Nurse and the Respiratory Therapist) were ready with our transport ventilator, monitoring equipment, travel drug box and all the necessary supplies for patient transport, we embarked on the road trip to Radiology, 2 floors below the ICU.
The elevator came to a halt and we thought we had arrived on the first floor, but then we noticed “B” for Basement was lit up and the door was not opening. It only took a few seconds before we realized we were stuck in the elevator with a critically ill patient! We all kind of laughed, nervously, thinking the door will open if we push the Door Open button harder and faster. When that didn’t work, we all looked at each other and said, Oh Shit! We hit the Emergency Call button and told the hospital operator what was going on and that she needed to send help immediately, as well as call the ICU and let them know what happened. At this point we started checking all our equipment, noting how much oxygen was left in the tank, that we had an Ambu Bag, enough vasoactive and sedation drips and our emergency medications available. Patient safety was our top priority so other than maintaining that, there was nothing else we could do but wait for help to arrive.
It was during the 50 minutes we spent stuck in the elevator that I realized this scary situation was actually the eye of the storm. It was the calm in the chaos that was my night. I noted how I was currently unable to complete nursing tasks, my labs were going to be drawn late and medications were going to be given late too. Everything seemed to slow down as I realized I could not control this situation and I had to just let it go. It was then that I realized all night I had been busy doing instead of being. I had let the demands of my job and the chaos of the unit distract me from my true purpose. And then it clicked, the most important nursing intervention at this time is being present with my patient.
A calm washed over me and I no longer felt irritated or frustrated in the elevator. I held my patient’s hand and let him know that he was not alone, that he is safe and we will not leave him. I was not 100% sure what he was understanding or hearing, but I knew that us yelling for help and explaining that the oxygen supply was limited had to be startling and traumatic to my lightly sedated patient. If anything, I was sure he could sense the tension and urgency in our voices so I changed my tone to be more calming and soothing. I set the intention for safety, peace and healing. I felt God’s gaurdian angels with us and took a deep breath of relief. I did not let go of my patient’s hand until the Fire Fighters arrived to rescue us and we safely returned to the ICU.
It was through this traumatic experience that my outlook shifted and I found a renewed sense of purpose and passion for nursing. I remembered what I already knew, the Art of Nursing is a way of being, not simply doing. That being present at the bedside is a way of providing compassionate care, in the moment, for the whole person (mind, body, emotions, spirit) to promote comfort and healing. Being present embraces the true nurse-patient connection which is the essence of nursing. It reminded me to Keep Calm and Nurse On.